Surgical appliance

ABSTRACT

A disposable surgical appliance for application to a living body to provide a protective enclosure for isolating an operating field from the surrounding atmosphere. The appliance includes an endless hollow flexible tubular member which is adhesively secured in fluid-tight relation to the body around the operating field. A constantly flowing supply of sterile air at preselected temperature and humidity is delivered into the member for discharge through a series of openings in the form of a plurality of relatively contiguous fluid jets which converge upwardly to form a continuous conical fluid curtain above the operating field. The conical curtain may be surrounded by one or more fluid walls, similarly formed by contiguous jets of fluid issuing through suitably arranged openings or nozzles in the member, the wall and curtain barring the entry of outside air and foreign particles into the enclosure and also performing a washing function on the surgeon&#39;&#39;s hands and any surgical instruments inserted or withdrawn through them.

United States Patent Von Otto SURGICAL APPLIANCE [72] Inventor: Robert E. Von Otto, Washington,

[73] Assignee: Henry E. Nichols, Washington, DC.

; a part interest [22] Filed: Oct. 16, 1970 [21] Appl.No.: 81,323

[52] US. Cl ..l28/l32, 239/559 [51] Int. Cl. ..A6lb 17/00 [58] Field of Search 128/132, 66; 239/559, 567,

[56] References Cited UNITED STATES PATENTS 3,556,089 1/1971 Frazier ..l28/66 2,305,289 12/1942 Coburg 128/132 R Primary Examiner-Richard A. Gaudet Assistant Examiner-G. F. Dunne Attorney-Watson, Cole, Grindle & Watson [15] 3,692,024 1 Sept. 19, 1972 [57] ABSTRACT A disposable surgical appliance for application to a living body to provide a protective enclosure for isolating an operating field from the surrounding at mosphere. The appliance includes an endless hollow flexible tubular member which is adhesively secured in fluid-tight relation to the body around the operating field. A constantly flowing supply of sterile air at preselected temperature and humidity is delivered into the member for discharge through a series of openings in the form of a plurality of relatively contiguous fluid jets which converge upwardly to form a continuous conical fluid curtain above the operating field. The conical curtain may be surrounded by one or more fluid walls, similarly formed by contiguous jets of fluid issuing through suitably arranged openings or nozzles in the member, the wall and curtain barring the entry of outside air and foreign particles into the enclosure and also performing a washing function on the surgeons'hands and any surgical instruments inserted or withdrawn through them.

8 Claims, 5 Drawing Figures BACKGROUND OF THE INVENTION In hospital operating rooms it has long been customary practice for the surgeons and operating room attendants, in addition to thoroughly scrubbing their hands and to wearing clothing which has been sterilized, also to wear face masks, all in an effort to prevent contamination of the operating field and the possible introduction into the patients incision of infection producing germs or virus. Also, to this same end, efforts have been made to isolate the operating field from its surroundings by means of physical barriers of various sorts.

However, in actual practice, it has been found that there nevertheless is experienced an undesirable rate of infections. It is believed that this is due, in part at least, to the inability by present techniques to completely isolate the operating field from the surrounding atmosphere, so as to avoid entry into the operating field and the incision of air borne germs, dust particles, or small particles of saliva or other liquids resulting from talking, coughing or sneezing of the surgeons and attendants. Moreover, the use of physical barriers or shields has resulted in reduced ease of access by the surgeon to the operating field.

SUMMARY OF THE INVENTION With these considerations in mind, it is the primary object of the invention to provide an appliance for maintaining the operating field completely isolated from the surrounding atmosphere by means of a generally conical curtain of fluid, such as air from a suitable source of filtered and sterilized air which may also be maintained at predetermined condition of temperature and humidity, the curtain being formed of a plurality of contiguous jets of fluid which serve to intercept and carry away any small foreign particles of solid or liquid material moving toward the enclosure and which also perform a washing or cleansing function on the hands of the surgeon as well as on any surgical instruments or other objects which are moved through the curtain into the operating field. At the same time, it is important to achieve these objects while affording a maximum of visibility and of ready access to the operating field by the surgeon.

Thus, in accordance with the invention, there is provided a disposable surgical appliance in the form of a hollow, preferably endless tubular member formed of a suitable plastic such as sheet polyethylene or other substantially fluid impermeable material having sufficient flexibility that it may conform in configuration to the surface of the human body or other living body to which it is applied to effect a fluid-tight seal with such surface, and preferably being coated with adhesive material for securing it to such surface. A constant flow of sterile air or other fluid at superatmospheric pressure is delivered into the hollow interior of the member from a suitable conventional source and is discharged therefrom through a plurality of closely spaced ports or openings in the form of upwardly converging contiguous jets defining a continuous conical fluid curtain cooperating with the tubular member for isolating the operating field from the surrounding atmosphere externally of the curtain. A supplemental fluid barrier or wall may be provided by a further plurality or openings or ports surrounding the first-mentioned ports, to eject further contiguous fluid jets surrounding the conical curtain to supplement the protective action of the latter. ltis an advantageous feature of the invention that the appliance may be disposed of after each use, because of the economy of its construction.

DETAILED DESCRIPTION OF THE INVENTION To promote an understanding; of the invention, reference will now be made to the preferred embodiment thereof illustrated in the accompanying drawings, and specific language will be used to describe the same. It will nevertheless be appreciated thatno limitation of the scope of the invention is thereby intended, such further modifications and alterations being contemplated as would normally occur to one skilled in the .art to which the inventionrelates.

In the accompanying drawings, FIG; 1 is a perspective view of a surgical appliance in accordance with the invention.

FIG. 2 is a plan view thereof;

FIG. 3 is a vertical section on the line 3-3 of FIG. 2;

FIG. 4 is a side elevation of the invention as applied to the body of a human patient, supported on an operating table which is illustrated in part only;

FIG. 4 is a plan view of the subject matter illustrated in FIG. 4. t

Referring now in detail to the accompanying drawings, the appliance of the present invention comprises a hollow inflatable tubular member 10 of any suitable preferably endless configuration, which is here illustrated for purposes of simplicity as being circular, though it is by no means restricted to such form. Such member 10 is formed of a suitable moisture resistant and substantially fluid impervious sheet material, such as sheet polyethylene or other sheet plastic having sufficient flexibility that its lower surface may readily conform in shape to the surface area of the body to which it is applied.

In order to firmly secure the member 10 against displacement and in firm sealing engagement with the patients body at any desired location thereon, the undersurface of the member 10 is preferably coated with a pressure sensitive adhesive as at 12, as is illustrated in FIG. 3. The member 10 serves as a reservoir or manifold for a supply of sterile fluid which is delivered thereinto through a flexible tube 14 at a sufficiently superatmospheric pressure to maintain the member 10 inflated and to expel the air in jet form through the openings or ports 16 and 18 at a sufficient velocity for the purposes hereinafter more fully described.

It will be understood that the conduit 14 communicates with any suitable source of filtered and sterilized air or other fluid which is preferably maintained at a preselected temperature and humidity and which normally constitutes the only fluid which is permitted to contact the operating field and the incision therein.

Formed in the upwardly presented surface of the member 10 are a plurality of closely spaced upwardly and inwardly directed fluid discharge openings 14, above mentioned. These are so spaced and arranged as to emit a plurality of generally contiguous jets of air or other fluid from the interior of the member, the close spacing of the jets being such as to cause them to merge with each other. The ports or openings 16 are disposed and arranged so that the jets converge upwardly to a zone of convergence, indicated generally by the reference numeral in FIG. 4. Thus they will jointly define a substantially conical fluid barrier or curtain 22, shown diagrammatically in FIGS. 3 and 4.

In addition, if desired, the further plurality of closely spaced fluid discharge ports 18 is arranged to surround the ports 16. Ports 18 are sufficiently closely spaced with respect to each other than the jets of fluid emerg ing from than will be contiguous and will merge to define a continuous fluid barrier or wall 24 as shown in FIG. 4, completely surrounding the conical curtain 22. Not only does the outer fluid barrier 24 tend to supplement the shielding action of the conical inner curtain 22, but in addition the upwardly and outwardly diverging relation or arrangement of the outer barrier 24, causes it to repel particles of liquid and dust from the area adjacent the operating field.

In the use of the invention, as generally illustrated in FIGS. 4 and 5, the lower surface of the tubular member 10 is placed over the patients body B at the desired location so that its inner periphery surrounds and defines the operating field F, as in FIG. 5. The body B will normally be supported on a conventional operating table T. The flexibility of the member 10 will preferably be such as to permit its distortion from itspreferred circular shape to a substantially oblong or oval shape if desired, as shown in FIG. 5. When suitably positioned around the operating field F, the member 10 is pressed against the patients body so that the pressure sensitive adhesive 12 on its undersurface may firmly adhere to the patients body to maintain a fluid-tight connection therewith, as well as to resist displacement. In some instances it may be desirable to supplement the holding or positioning action of the adhesive coating 12 by supplemental tabs or strips of conventional adhesive tape 34, as shownin FIGS. 4 and 5.

After being thus applied to the patients body, the member 10 is connected to a suitable conventional source (not shown) of filtered, sterilized air or other fluid at the desired temperature, humidity and pressure. It is important that the fluid which passes through the member 10 may be of sufficiently high humidity as to prevent evaporation of moisture from the incision, and may have entrained therein any suitable medication.

The pressurized fluid entering the interior of the member 10 through the tube 14 will inflate the member as shown in FIGS. 3, 4 and 5, and the pressurized fluid within the member will be discharged through both series or pluralities of ports 16 and 18 to form and maintain the conical inner barrier or curtain 22 and the external supplemental barrier or fluid wall 24.

With such an arrangement, the surgeon has maximum visibility of and access to the operating field. His hands may readily pass through the fluid barriers 22 and 24, which will exert a washing and cleansing effect both on the surgeons hands and on any instrument or objects inserted into the operating field. Moreover, because of the complete isolation of the operating field by the conical curtain 22, it is made possible for the surgeon to dispense with the usual face mask without endangering the patient. It will be obvious that the breath of the surgeon and the various attendants, as well as foreign particles resulting from talking, sneezing, coughing, will be barred and diverted from the operating field in the first instance by the outwardly diverging outer wall or barrier 24 and, any particles which might penetrate that barrier are completely isolated from the operating field by the conical curtain 22, such curtain, together with the member 10 and the operating field itself defining a conical space which is enclosed on all sides to be fully isolated from the surrounding atmosphere.

Upon completion of the operation, the member 10 may be removed simply by pulling away first the strips of adhesive tape 34 where these are employed, and then by pulling upwardly on the member 10 sufficiently to release the connection with the patients body afforded by the pressure sensitive adhesive 12. It is an important practical aspect of the invention that the member 10, because of the simplicity and the cheapness of its construction, may be discarded after each use and that a completely new and fully sterilized such member may be employed for each use.

Manifestly, the fluid supplied to the member 10 may comprise a supply of specially conditioned air using known psychrometric principles and/or supplying nuclear and/or chemical preparations. If conditions warrant, there may be provided return or exhaust systems for the air.

While the invention has been herein described in its preferred field of use as a surgical shield, it is capable of various other uses. For instance it may be employed to maintain surgical instruments in a sterile atmosphere, or may be used industrially to protect delicate instruments from air-borne dust particles.

In any selected field of use, it provides particle control and has particle repelling ability, especially and including those particles causing infectious disease, malfunctioning of manufactured parts, damage to fine instrumentation and the like. It also provides shielding between the sterile area and operating personnel as above described. 1

Though, in its preferred embodiment, the member 10 is in the form of a toroidal ring, it may assume other shapes adapted for enclosing a predetermined area, to form a protective fluid shield or cone, therearound.

It will be thus apparent that the invention is capable of various uses, and of various modifications in its structure, without departing from the inventive concept as defined in the appended claims.

Having thus described my invention, 1 claim:

1'. A surgical appliance for application to a living body to maintain a protective fluid shield for isolating an area of said body from the surrounding atmosphere, comprising a flexible, hollow, inflatable tubular member of endless configuration, having upper and lower surfaces; means for securing said member in fluid-tight relation with the surface of a living body around the preselected area where a surgical incision is to be made; means for delivering into said tubular member a constant flow of sterile fluid at superatmospheric pressure; said member being formed with a plurality of closely spaced upwardly and inwardly directed fluid discharge openings distributed in an endless configuration around its upper surface, and arranged to emit a plurality of contiguous jets of said fluid toward a common zone of convergency above said area, said openings being sufficiently closely spaced that the fluid and jets emitted therefrom merge with each other, and define a continuous conical fluid curtain cooperating with said member for isolating said area from thesurrounding atmosphere.

2. A surgical appliance as defined in claim 1, wherein said member is formed with a further plurality of closely spaced fluid discharge openings through its upper surface around said first mentioned plurality of openings, the openings of said second plurality being sufficiently closely spaced that the jets of fluid emerging therefrom merge and define a continuous fluid wall completely surrounding said conical fluid curtain.

3. A surgical appliance as defined in claim 2, in which the openings of said second plurality are arranged to emit a plurality of upwardly divergent fluid jets.

4. A surgical device as defined in claim 1, in which said means for delivering fluid into said tubular member comprises a source of sterile gas at a preselected temperature and humidity.

5. A surgical appliance as defined in claim 4 in which said gas is air.

. 6. The surgical appliance as defined in claim 1, in

which said tubular member is formed of a relatively thin flexible sheet plastic material to be readily disposable after use.

7. A surgical appliance for application to a living body to maintain a protective fluid shield for isolating an area of said body from the surrounding atmosphere, comprising a flexible hollow inflatable tubular member of endless configuration, having upper and lower surfaces; means for securing said member in fluid-tight relation with the surface of a living body around the preselected area where a surgical incision is to be made; and means for delivering into said tubular body a constant flow of sterile fluid at superatmospheric pressure; said member including means for discharging said fluid as a continuous upwardly directed conical fluid curtain surrounding said area and converging at a location thereabove.

8. A surgical appliance as defined in claim 7, wherein said member further includes means for discharging additional said fluid as a continuous fluid wall completely surrounding said conical fluid curtain. 

1. A surgical appliance for application to a living body to maintain a protective fluid shield for isolating an area of said body from the surrounding atmosphere, comprising a flexible, hollow, inflatable tubular member of endless configuration, having upper and lower surfaces; means for securing said member in fluid-tight relation with the surface of a living body around the preselected area where a surgical incision is to be made; means for delivering into said tubular member a constant flow of sterile fluid at superatmospheric pressure; said member being formed with a plurality of closely spaced upwardly and inwardly directed fluid discharge openings distributed in an endless configuration around its upper surface, and arranged to emit a plurality of contiguous jets of said fluid toward a common zone of convergency above said area, said openings being sufficiently closely spaced that the fluid and jets emitted therefrom merge with each other, and define a continuous conical fluid curtain cooperating with said member for isolating said area from the surrounding atmosphere.
 2. A surgical appliance as defined in claim 1, wherein said member is formed with a further plurality of closely spaced fluid discharge openings through its upper surface around said first mentioned plurality of openings, the openings of said second plurality being sufficiently closely spaced that the jets of fluid emerging therefrom merge and define a continuous fluid wall completely surrounding said conical fluid curtain.
 3. A surgical appliance as defined in claim 2, in which the openings of said second plurality are arranged to emit a plurality of upwardly divergent fluid jets.
 4. A surgical device as defined in claim 1, in which said means for delivering fluid into said tubular member comprises a source of sterile gas at a preselected temperature and humidity.
 5. A surgical appliance as defined in claim 4 in which said gas is air.
 6. The surgical appliance as defined in claim 1, in which said tubular member is formed of a relatively thIn flexible sheet plastic material to be readily disposable after use.
 7. A surgical appliance for application to a living body to maintain a protective fluid shield for isolating an area of said body from the surrounding atmosphere, comprising a flexible hollow inflatable tubular member of endless configuration, having upper and lower surfaces; means for securing said member in fluid-tight relation with the surface of a living body around the preselected area where a surgical incision is to be made; and means for delivering into said tubular body a constant flow of sterile fluid at superatmospheric pressure; said member including means for discharging said fluid as a continuous upwardly directed conical fluid curtain surrounding said area and converging at a location thereabove.
 8. A surgical appliance as defined in claim 7, wherein said member further includes means for discharging additional said fluid as a continuous fluid wall completely surrounding said conical fluid curtain. 